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Archive for July, 2009

If I Had a Dollar……..

Posted by realityrounds on July 31, 2009

………for every time I answered these same patient questions/concerns over and over again, I would be a millionaire.

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  • “How much does the baby weigh?” Most often asked by dad while baby is crowning.
  • “I don’t have enough breast milk yet. I will just bottle and breast feed.” Which translates to bottle only.
  • “Can the baby see ?” Yes, you did not give birth to a puppy.  Newborns can see about six inches in front of their face.  Approximately the same distance from mom’s breast to mom’s face.
  • “How much longer?!” (Until the baby’s born)  Oh, don’t ask me.  I am always wrong.
  • Image of Nurse RR unpacking patients luggage full of hospital baby blankets, T-shirts, alcohol wipes, towels, sheets, pillow cases, diapers….”You mean we can’t take this stuff home?” No, but you can take your baby.
  • “This was the first time I have ever taken Heroin.” Yes, because we all know the best time to experiment with drugs is when you’re pregnant.  My head hurts from falling off the turnip truck.
  • “How long do we have to wait before having sex again?” Most often asked by dad while baby is crowning.
  • “Can you fill out my WIC papers?” Yes
  • “Do you validate parking?” Yes
  • “We don’t need a car seat.” Yes, you do.
  • Image of Nurse RR walking into patient room in the middle of July, to find baby dressed in hat, down parka, and swaddled with knit blanket.  “Baby cold”. No, baby over heated.  Babies need to be dressed like you dress yourself, with one more layer, like an extra blanket.  Over heating has been linked to Sudden Infant Death Syndrome (SIDS).  Please, stop listening to your mother-in-law.
  • “Showers are unhealthy until 30 days post delivery.” Please stop listening to your mother-in-law.
  • “When will we get the Birth Certificate?” (usually asked about a thousand times a day close to April 15th, tax day).  It can take up to three months, longer if your state is bankrupt.

That is my millionaire list.  Anyone have any additions?

RR

Posted in breastfeeding, child birth, health, infant health, nursing, women's health | Tagged: , , , , | 13 Comments »

July 30th, 2003 at 10:55pm, My World Changed Forever……..

Posted by realityrounds on July 30, 2009

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I felt like I fought a war to bring you into the world.  A war full of pain and anxiety and blood and sweat and tears.  The moment I held you in my arms, I surrendered.  My life was no longer my own.  I would sob when I looked at you.  You were so beautiful.  It was painful to stare at you for too long.  How could I be responsible for so much beauty?

You are a gift.  Your name means “beautiful” and “forest” and “darkness” and you are so much more than your name.  We celebrated the “Joy of a Daughter.”  And my life has been filled with joy ever since.

Happy Birthday my love!

RR

Posted in Uncategorized | 6 Comments »

My Cat Ate My Daughters Umbilical Cord

Posted by realityrounds on July 29, 2009

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Not while it was still attached to her, thank God.  (Because that would be really gross and creepy, unlike the TMI story I’m about to tell).

I am not a sentimental, scrap booking, volunteer for the PTA type of parent.  I’m just not an artsy fartsy, or touchy-feely type o’ gal.  My wedding dress is still in a plastic garbage bag hanging in my closet, and it took me 3 years after the wedding to order a wedding album.  I still have not made any baby books for my two girls, who are now 5 and 4 years old.

So, flashback 5 years.  I am an exhausted new mom, with a colicky newborn.  My days were filled with sleep deprived all-encompassing newborn care.  Nursing, crying, diapers,….repeat ad nauseam.  I waited with anticipation for all the newborn milestones; coos, grasping, rolling over, cord falling off………  Hmmm, why does she still have her cord still attached? Here we are 4 weeks after birth, and my baby still has a dried up chunk of decomposing umbilical cord still attached.  The “average” cord falls of by 2 weeks of life, but my daughter is above average.  Her cord would not budge.  I just got used to it.  Didn’t think about it.  Until one day, when it was gone!  It just disappeared, to be replaced with a cute little belly button.

Fast forward two years after her birth.  My evil little black cat is being very feisty.  She is chasing and playing with what I assume to be a bug, underneath my king sized bed.  She starts to pounce on this “bug” and runs around my bedroom with it in her mouth.  I become curious.  I grab the cat, open her mouth, and pull out………my daughter’s umbilical cord.  It is dried up, brown, and still has the indentations from where the clamp was placed.

Don’t be so judgmental.  There are plenty of moms out there who save their babies umbilical cords for scrapbooks, or who store their own placentas in the freezer (you know who you are).  I just “accidentally” saved my daughter’s cord for over two years, and I “saved” it from being ingested by my evil cat.  This is normal, right?

RR

Posted in health, infant health, moms | Tagged: , , , | 14 Comments »

The Unnecesarean.com (How’s that for subtle advertising?)

Posted by realityrounds on July 29, 2009

One of my favorite blogs is The Unnecesarean, authored by Jill.  (She is so famous she only needs one name, like Madonna). According to her site:

The Unnecesarean is a patient advocacy Web site that pulls back the curtain on the practice of prophylactic cesarean surgery for suspected fetal macrosomia and illuminates the experiences of women who have been harmed by the aggressive practice of defensive medicine. The site provides information about preventing an unnecessary cesarean and resources for making fully-informed decisions about childbirth while offering an irreverent take on the maternity care crisis in the United States and beyond. The Unnecesarean is written from the perspective of a former patient that refused a coercive recommendation of an unnecessary cesarean, gave birth vaginally to a healthy baby and later found that the Midwives Model of Care better met her needs as a pregnant woman.

I like her site because I find it informative, funny, entertaining, and because she does not seem to be a jerk.  I may not agree with everything she posts, but she always allows a forum for intelligent discourse in her comments.  She recently had some techno-geek, blog name- stealing, unscrupulous, activity that rendered her blog dormant.  So she renamed it, and it built it back to all it’s glory.  Click below to check it out!

The Unnecesarean.com

RR

Posted in Uncategorized | Tagged: , , | 6 Comments »

“Forcing” a Catholic Nurse to Assist with an Abortion: A Nurse’s Perspective

Posted by realityrounds on July 28, 2009

There is a story coming out of New York that is lighting a fire in the media and on the internet.  According to the New York Post, a devout Catholic nurse was allegedly forced to assist in a late term abortion procedure at Mount Sinai Hospital in New York.   Below are excerpts from the New York Post article:

A Brooklyn nurse claims she was forced to choose between her religious convictions and her job when Mount Sinai Hospital ordered her to assist in a late-term abortion against her will.

The hospital even exaggerated the patient’s condition and claimed the woman could die if the nurse, a devout Catholic, did not follow orders, the nurse alleges in a lawsuit.

The married mother of a year-old baby was 30 minutes into her early-morning shift when she realized she had been assigned to an abortion. She begged her supervisor to find a replacement nurse for the procedure. The hospital had a six-hour window to find a fill-in, the suit says.

Bosses told the weeping Cenzon-DeCarlo the patient was 22 weeks into her pregnancy and had preeclampsia, a condition marked by high blood pressure that can lead to seizures or death if left untreated.

Her pleas were rejected, and instead she was threatened with career-ending charges of insubordination and patient abandonment, according to the lawsuit, filed Tuesday in Brooklyn federal court.

Taking into account that the whole story of what happened is not represented in this article, and that there are a lot of questions left unanswered, I will try and piece together what went wrong with this case.  *I am not going to address the moralities of abortion, this post is about nursing.*

For a little real life perspective on my opinions, I have worked in women’s and infant’s health for 20 years (I became a nurse at the age of 5). I have worked in a student gynecology clinic, as a sexual health educator, as an OB and NICU staff nurse, as a charge nurse, as a clinical nurse specialist, and as a nurse manager.  Yes, I have been around the block.  What would I have done if a nurse came sobbing to me that she did not want to care for a patient who was getting a late term abortion?

In my career there have been on occasion, situations where a nurse refuses (usually it is begging and pleading) to get out of an assignment because of religious or emotional issues.  I have had nurses “refuse” to take care of a dying 24 weeker, because they just lost a baby themselves months earlier.  I have had nurses “refuse” to care for a mom undergoing an elective termination for a lethal anomaly at 17 weeks, because of religious reasons.  I have had nurses “refuse” to take care of the family laden with swastika tattoos because they were Jewish, and it was offensive to them.  So what did I do?  I switched their assignments.  It is not rocket science.  The other nurses who had to give up an assignment and switch might complain and moan, but tough shit.

Nurses are not robots.  We all come with life histories, and stories, and religious beliefs, and emotions.  I get that.  If a patient requests a different nurse, guess what we do?  We switch nurses!  So why can’t a nurse request the same thing.  I am not talking about a nurse who requests an assignment change because it is too hard, and she won’t get a break or whatever.  I am talking full fledged, Conscience Clause inducing morality here.  Again, I can’t for the life of me think of why they could not have assigned that patient to another nurse.  It was an OR case, and there had to be more than one nurse working that day.

Nurse do have a moral obligation to care for their patients, no matter what that patients views of humanity are.  If there were truly no other nurses to care for that mom, and that mom was in danger of dying or suffering irreparable bodily harm if she continued the pregnancy, than that nurse had an obligation to her patient.  Her inactions could have led to the death of the mother also.

According to the New York Post, the nurse made it very clear as a condition of hire that she would never assist in an abortion.  It is unclear as to why this nurse would choose to work in a hospital that performed abortions, and it is unclear as to why the hospital would hire a nurse who admitted she would not assist in a procedure  that the OR regularly does.  Something just does not add up to me.

I have never come across a nurse manager who has forced a sobbing nurse  to assist in a procedure she was morally opposed to .  It makes me wonder how the nurse in question protested against her assignment.  Did she initially complain, than give in, and then feel victimized after the fact?  I will be curious to hear the other side of this story.

As in most cases like these, a lot of drama could have been avoided by simple communication and planning.  The whole situation is tragic and sad.  I hope it is not being exploited by either side to promote an agenda.  That will prove to be no good.

RR


Posted in abortion, ethics, health, nursing | Tagged: , , , , | 24 Comments »

Realities of a Real Life Baby Nurse

Posted by realityrounds on July 27, 2009

Every working mom has some form of guilt in leaving their kids in daycare or with nannies, while they go to work.  It can be tough, real tough.  I have mentioned before how I have missed some milestones with my kids while I was at work, like my daughter’s first tooth coming out.  Other working moms have told me stories of how their kids said their first words, or took their first steps with the nanny.  Word of advice to nannies, don’t tell the mom about her babies first steps with you.  Keep quiet, and act real surprised if the mom tells you how she just saw her babies first steps!

Neonatal nurse-parents, have their own feelings of working guilt.  We are leaving our babies at home/daycare, to take care of others/strangers, babies.   It’s kind of ironic.  I have discussed this very weird sense of guilt many times with my NICU peers.  It really is an irrational sense of guilt, but isn’t most mommy-guilt irrational?

The other day I had planned a nice summer day with my girls.  Nothing earth-shattering, just some outside fun, arts and crafts, etc.  My husband was at work, and I got a desperate call from work.  The unit was hitting a critical mass, and they were in dire need of some extra help.  Moral dilemma coming my way.  Do I continue bonding with my girls, or do I help out my colleagues (and the patients), in their time of need?

I packed my kids up and sent them to my sister’s house.

Mommy!  Why are you going to work?- missing-toothed kid.

“There is an emergency at work.  They need my help.”-guilt ridden mom.

“Emergency.  Did someone die?”-missing-toothed- too- smart- for- her- own-good- kid.

“No!  Lot’s of babies need to be taken care of.” -guilt ridden mom.

So I left my kids, yet again, to take care of stranger’s kids.  I loved the patients I took care of that crazy day, and I loved their families.  It was very rewarding teaching the parents how to care for their fragile preemies, and answer their questions, and comfort them, while my sister comforted my kids.

I often think of quitting nursing, at least until my kids are grown.  Don’t get me wrong.  I LOVE my job.  Corny as it sounds, caring for newborns and nurturing new families is my calling in life.  I have never, ever, not once, regretted the career path I took.  But as any mom can relate to, my kids are my number one priority in life.  I could quit today, and feel the guilt of yet another experienced nurse letting at-risk families sway in the wind, so she could care for her own family.  I saw the look of gratitude the parents gave me while I helped them care for their newborns.  I saw the look of disappointment in my daughters eyes as I left them, again, to care for others.

Which look will pull me away?

RR

Posted in NICU, ethics, health, moms, nursing, women's health | Tagged: , , , , | 13 Comments »

Friday Fun Fact: The Tooth Fairy

Posted by realityrounds on July 24, 2009

toothfairy2smallMy daughter lost her first tooth yesterday, while I was at work…..sigh.  Another child milestone missed because I was working.  OK enough mom guilt.  The tooth fairy left $5 under her pillow.  What happened to leaving a quarter?

HISTORY OF THE TOOTH FAIRY

When a child loses a tooth, most children will place their tooth either under their pillow, or for some, in a glass of water beside their beds before going to sleep that night. Their hopes are that the Tooth Fairy will come during the night and replace the tooth with a coin or these days a monetary note.

Fairy Tinkerbell

The most useful purpose of the Tooth Fairy myth in this day and age is to give children something to look forward to when they lose a tooth, especially as some children become quite concerned about the loss of their first teeth.But where did it all start?

In European folklore there exist many myths, superstitions and legends. The tooth fairy, although widespread appears to have many different variations, but most of them deal with teeth having an element of power, even able to ward off evil.

The Vikings used to pay their children a tooth fee, simply as it sounds, a fee for the use of the children’s teeth which were then strung onto necklaces and other jewellery. The Vikings believed that the power of the children’s teeth would aid them in battle.

One of the more common stories is that the teeth were buried so as to hide them from witches and evil spirits who would be able to use the power of the lost tooth and place a curse of the child much in the way that voodoo works with hair.

By planting the tooth in the garden near their house they were also trying to assist the growth of the new adult tooth in its place.
As some towns became more crowded with buildings and less land, the teeth were then buried in flowerpots and eventually moved indoors to be ‘buried’ under a pillow.
Some cultures then introduced the myth of the Tooth Mouse, obviously a little mouse who would scamper around town and take the children’s teeth.

The transformation from mouse to fairy for some cultures (some still use the mouse who takes the teeth and also leaves treasures under the pillow) came after the publication of “La Bonne Petite Souris,” in the 18th Century in which the mouse in the story hides under the pillow of an evil King, changes into a fairy and knocks out all his teeth. So eventually the story changed again into a fairy who would take the teeth, leaving a small reward in its place.

Of course it doesn’t end there. Then the children wanted to know what happened to the teeth, so over the years many parents have had many different answers to this question. For example:

- Gives them to newborn babies who don’t have any teeth as yet.
- Gives the teeth to Santa to give to dolls in his workshop or turn into jewellery.
- Turns them into seashells for fish to live in
- Turns the teeth into the stars of the night sky.
- Plants them in her garden and grows children
- Grinds them into fairy dust that she uses to enable her to fly.
- Makes tooth castles in the sky.

Whatever the answer, the story of the Tooth Fairy has endured for hundreds of years and will surely endure for hundreds more to come.

*Happy Friday!*
RR
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Posted in Uncategorized | Tagged: , | 8 Comments »

Alone

Posted by realityrounds on July 23, 2009

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My husband took this picture when he was left alone in my Labor and Delivery room while I was being wheeled away to the OR for a C-section. We had gone through a very scary time of prolonged labor, staff asking me to sign a consent for an emergency C-section due to fetal bradycardia, while I was on all fours and sobbing, stabilization, and three hours of pushing that led nowhere.

The staff left him alone so I could be prepped for surgery, and they called him in to the OR about 15 minutes later.  We often don’t think about how our partners are doing during the whole labor and delivery process.  They have zero control over the situation.  My husband had two people he loved very much going through a precarious situation, yet he was powerless to do anything.  I would have hated to be in his shoes.

He told me he took this picture because he was so nervous about me going in to have surgery, and he was alone, and he did not know what else to do.  So he took a picture of the empty space, where the bed was, where I was moments before. Will I be left alone? I never really thought about how terrifying that was for him.

RR

Posted in child birth, health | Tagged: , , | 25 Comments »

“Shut Up and Push!”

Posted by realityrounds on July 22, 2009

The Chicago Tribune has a follow-up on the notorious story of  Obstetrician Dr. Scott Pierce who “allegedly” denied a woman in labor pain medication, and was verbally and physically abusive to her during labor.  For a more detailed account click here.  In the lawsuit filed against Dr. Pierce, the patient Catherine Skol, alleges that he denied her an epidural, performed unnecessary painful vaginal exams, swore repeatedly at her, told her she was going to hemorrhage before the baby was even born, talked about performing an abortion on another patient, while in the room with Ms. Skol, and then stitched her up without proper use of anesthetic.  (Good times).  There are witnesses to these behaviors by not only the family, but the nurses, residents and other staff on that night.

So here is a multiple choice question.  What disciplinary action did Dr. Pierce receive from his peers?:

A.  He was sentenced to a pillow fight with the director of Obstetric services.

B.  He was branded with the Scarlet letter “A” for asshole.

C.  He was fined $500 and placed on one year probation by the Illinois Department of Financial and Professional Regulation.

D.  He was forced to be held down by his wife while passing a kidney stone, with no pain medication, while being yelled at by  an attending physician, who inserted a 16 gauge IV catheter ( FYI:that’s a catheter about as big as a garden hose), just for fun.

Cue Jeopardy music while I wait for your final answer.

I wonder what would have happened to a nurse if she/he treated a patient like Ms. Skol was treated.  Hmmmm.

RR


Posted in child birth, ethics, health, nursing, women's health | Tagged: , , , , , | 14 Comments »

Pull Out Party

Posted by realityrounds on July 21, 2009

Are you freakin’ kidding me?  The New York Times is sounding off on how the withdrawal method, or pull out method of “birth control” is getting a bad rap.  It is profiling a research article from the journal Contraception that states the withdrawal method is as good at preventing pregnancies as is using a condom.  I’m calling a Code Bullshit.

According to the article if the withdrawal method is used correctly 100% of the time (yeah, right) there is about a 4% chance in a year that the couple will become pregnant.  If condoms are used correctly 100% of the time (yeah, right) there is a 2% chance the couple will become pregnant.  The statistics with actual human beings are :  “Typical use of withdrawal leads to pregnancy 18 percent of the time, they write; for typical use of condoms 17 percent of the time.”

Call me a cynic but any form of birth control that relies solely on male responsibility should not be advertised as the next best thing.  Yes, the withdrawal method probably works fine for those long-term, committed, married couples, but they’re not having any sex anyway.

RR

Posted in child birth, health, women's health | Tagged: , , , , , | 10 Comments »